This project aimed to assess the impact of an 8-day military training exercise on cognitive performance, and track its recovery in periods of reduced training load and partially restored sleep.
Background
Military personnel often work in challenging multi-stressor environments, where sleep loss is inevitable. Sleep loss can impair multiple cognitive domains, which can have disastrous consequences in military contexts.
Method
A total of 57 male and female soldiers undergoing the Australian Army combat engineer Initial Employment Training course were recruited and tracked over a 16-day study period which included an 8-day field-based military training exercise. Cognitive performance was assessed via a computerised battery at seven time points across four sequential study periods; 1) baseline (PRE), 2) military field training exercise which included total sleep deprivation (EX-FIELD), 3) training exercise at simulated base with restricted sleep opportunities (EX-BASE), and 4) a 3-day recovery period (REC). Subjective load, fatigue, and sleep were evaluated continuously via questionnaire and actigraphy.
Results
Psychomotor speed, reaction time, visual tracking and vigilance were impaired following the EX-FIELD period (p < 0.05). The majority of affected measures recovered 2 days following EX-FIELD, being no different in EX-BASE compared to PRE.
Conclusion
The sensitivity of the cognitive tests to sleep restriction, and recovery, indicates they can help assess operational readiness in military personnel. Future studies should explore other indicators of, and strategies to preserve, operational readiness in military personnel.
Application
This study highlights the impact of work-induced fatigue on cognitive performance, and would interest authorities seeking to preserve operational readiness.
ÅbergM. A.PedersenN. L.TorénK.SvartengrenM.BäckstrandB.JohnssonT.Cooper-KuhnC. M.AbergN. D.NilssonM.KuhnH. G. (2009). Cardiovascular fitness is associated with cognition in young adulthood. Proceedings of the National Academy of Sciences of the United States of America, 106(49), 20906–20911. https://doi.org/10.1073/pnas.0905307106
2.
AdamM.RéteyJ. V.KhatamiR.LandoltH. P. (2006). Age-related changes in the time course of vigilant attention during 40 hours without sleep in men. Sleep, 29(1), 55–57. https://doi.org/10.1093/sleep/29.1.55
3.
ÅkerstedtT.WrightK. P. (2009). Sleep loss and fatigue in shift work and shift work disorder. Sleep Medicine Clinics, 4(2), 257–271. https://doi.org/10.1016/j.jsmc.2009.03.001
4.
AlholaP.Polo-KantolaP. (2007). Sleep deprivation: Impact on cognitive performance. Neuropsychiatric Disease and Treatment, 3(5), 553–567.
5.
BannaiA.TamakoshiA. (2014). The association between long working hours and health: a systematic review of epidemiological evidence. Scandinavian Journal of Work, Environment & Health, 40, 5–18. https://doi.org/10.5271/sjweh.3388
6.
BasnerM.SavittA.MooreT. M.PortA. M.McGuireS.EckerA. J.NasriniJ.MolliconeD. J.MottC. M.McCannT.DingesD. F.GurR. C. (2015). Development and validation of the cognition test battery for spaceflight. Aerospace Medicine and Human Performance, 86(11), 942–952. https://doi.org/10.3357/AMHP.4343.2015
7.
BelenkyG.WesenstenN. J.ThorneD. R.ThomasM. L.SingH. C.RedmondD. P.RussoM. B.BalkinT. J. (2003). Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: A sleep dose-response study. Journal of Sleep Research, 12(1), 1–12. https://doi.org/10.1046/j.1365-2869.2003.00337.x
BowieC. R.HarveyP. D. (2006). Administration and interpretation of the trail making test. Nature Protocols, 1(5), 2277–2281. https://doi.org/10.1038/nprot.2006.390
10.
ColeR. J.KripkeD. F.GruenW.MullaneyD. J.GillinJ. C. (1992). Automatic sleep/wake identification from wrist activity. Sleep, 15(5), 461–469. https://doi.org/10.1093/sleep/15.5.461
De GennaroL.FerraraM.CurcioG.BertiniM. (2001). Visual search performance across 40 h of continuous wakefulness: Measures of speed and accuracy and relation with oculomotor performance. Physiology & Behavior, 74(1–2), 197–204. https://doi.org/10.1016/s0031-9384(01)00551-0
13.
DiDomenicoA.NussbaumM. A. (2008). Interactive effects of physical and mental workload on subjective workload assessment. International Journal of Industrial Ergonomics, 38(11–12), 977–983. https://doi.org/10.1016/j.ergon.2008.01.012
14.
DoranS. M.Van DongenH. PDingesD. F. (2001). Sustained attention performance during sleep deprivation: evidence of state instability. Archives Italiennes de Biologie, 139(3), 253–267. https://doi.org/10.4449/aib.v139i3.503
15.
DorrianJ.RogersN. L.DingesD. F. (2005). Psychomotor vigilance performance: Neurocognitive assay sensitive to sleep loss Sleep deprivation: Clinical issues, pharmacology and sleep loss effects. Marcel Dekker (pp. 67–98).
16.
DrummondS. P.PaulusM. P.TapertS. F. (2006). Effects of two nights sleep deprivation and two nights recovery sleep on response inhibition. Journal of Sleep Research, 15(3), 261–265. https://doi.org/10.1111/j.1365-2869.2006.00535.x
17.
DupuyO.RenaudM.BhererL.BosquetL. (2010). Effect of functional overreaching on executive functions. International Journal of Sports Medicine, 31(9), 617–623. https://doi.org/10.1055/s-0030-1255029
18.
DurmerJ. S.DingesD. F. (2005). Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 25(1), 117–129. https://doi.org/10.1055/s-2005-867080
19.
DutheilF.BessonnatB.PereiraB.BakerJ. S.MoustafaF.FantiniM. L.MermillodM.NavelV. (2020). Napping and cognitive performance during night shifts: a systematic review and meta-analysis. Sleep, 43(12), zsaa109. https://doi.org/10.1093/sleep/zsaa109
20.
FriedlK. E.MaysM. Z.KramerT. R.ShippeeR. L. (2001). Acute recovery of physiological and cognitive function in US army ranger students in a multistressor field environment. Army Research Inst of Environmental Medicine Natick Ma.
21.
GoodC. H.BragerA. J.CapaldiV. F.MysliwiecV. (2020). Sleep in the United States military. Neuropsychopharmacology, 45(1), 176–191. https://doi.org/10.1038/s41386-019-0431-7
22.
GrantD. A.HonnK. A.LaytonM. E.RiedyS. M.Van DongenH. P. A. (2017). 3-minute smartphone-based and tablet-based psychomotor vigilance tests for the assessment of reduced alertness due to sleep deprivation. Behavior research methods, (3), 1020–1029.
23.
GrierT.DinkelooE.ReynoldsM.JonesB. H. (2020). Sleep duration and musculoskeletal injury incidence in physically active men and women: A study of U.S. Army Special Operation Forces soldiers. Sleep Health, 6(3), 344–349.
24.
HamarslandH.PaulsenG.SolbergP. A.SlaathaugO. G.RaastadT. (2018). Depressed physical performance outlasts hormonal disturbances after military training. Medicine and Science in Sports and Exercise, 50(10), 2076–2084. https://doi.org/10.1249/MSS.0000000000001681
25.
HarrisW. C.HancockP. A.HarrisS. C. (2005). Information processing changes following extended stress. Military Psychology, 17(2), 115–128. https://doi.org/10.1207/s15327876mp1702_4
26.
HarrisonE.GlickmanG. L.BeckerleyS.TaylorM. K. (2017). Self-reported sleep during U.S. navy operations and the impact of deployment-related factors. Military Medicine, 182(S1), 189–194. https://doi.org/10.7205/MILMED-D-16-00078
27.
HarrisonY.HorneJ. A. (2000). The impact of sleep deprivation on decision making: a review. Journal of Experimental Psychology. Applied, 6(3), 236–249. https://doi.org/10.1037//1076-898x.6.3.236
28.
HartS. G.StavelandL. E. (1988). Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Advances in Psychology, 52, 139–183. Elsevier. https://doi.org/10.1016/s0166-4115(08)62386-9
29.
HartzlerB. M. (2014). Fatigue on the flight deck: the consequences of sleep loss and the benefits of napping. Accident Analysis & Prevention, 62, 309–318. https://doi.org/10.1016/j.aap.2013.10.010
30.
HaslamD. R. (1985). Sleep deprivation and naps. Behavior Research Methods, Instruments, & Computers, 17(1), 46–54. https://doi.org/10.3758/bf03200896
HeatonK. J.MauleA. L.MarutaJ.KryskowE. M.GhajarJ. (2014). Attention and visual tracking degradation during acute sleep deprivation in a military sample. Aviation, Space, and Environmental Medicine, 85(5), 497–503. https://doi.org/10.3357/asem.3882.2014
33.
LiebermanH. R.BathalonG. P.FalcoC. M.KramerF. M.MorganC. AIIINiroP. (2005). Severe decrements in cognition function and mood induced by sleep loss, heat, dehydration, and undernutrition during simulated combat. Biological Psychiatry, 57(4), 422–429. https://doi.org/10.1016/j.biopsych.2004.11.014.
34.
LiebermanR.BathalonG. P.FalcoC. M.MorganC. A.NiroP. J.TharionW. J. (2005). The fog of war: decrements in cognitive performance and mood associated with combat-like stress. Aviation, Space, and Environmental Medicine, 76(7), C7–C14.
35.
LiebermanH. R.CastellaniJ. W.YoungA. J. (2009). Cognitive function and mood during acute cold stress after extended military training and recovery. Aviation, Space, and Environmental Medicine, 80(7), 629–636. https://doi.org/10.3357/asem.2431.2009
36.
LiebermanH. R.NiroP.TharionW. J.NindlB. C.CastellaniJ. W.MontainS. J. (2006). Cognition during sustained operations: Comparison of a laboratory simulation to field studies. Aviation, Space, and Environmental Medicine, 77(9), 929–935.
37.
LimJ.DingesD. F. (2008). Sleep deprivation and vigilant attention. Annals of the New York Academy of Sciences, 1129(1), 305–322. https://doi.org/10.1196/annals.1417.002
38.
LimJ.DingesD. .F (2010). A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychological Bulletin, 136(3), 375–389. https://doi.org/10.1037/a0018883
39.
MargolisL. M.MurphyN. E.MartiniS.SpitzM. G.ThraneI.McGrawS. M.BlatnyJ. M.CastellaniJ. W.RoodJ. C.YoungA. J.MontainS. J.GundersenY.PasiakosS. M. (2014). Effects of winter military training on energy balance, whole-body protein balance, muscle damage, soreness, and physical performance. Applied Physiology, Nutrition, and Metabolism, 39(12), 1395–1401. https://doi.org/10.1139/apnm-2014-0212
40.
MatthewsG.Reinerman-JonesL. E.BarberD. J.AbichJ. (2015). The psychometrics of mental workload. Human Factors: The Journal of the Human Factors and Ergonomics Society, 57(1), 125–143. https://doi.org/10.1177/0018720814539505
41.
McCaffreyR. J.WesterveltH. J. (1995). Issues associated with repeated neuropsychological assessments. Neuropsychology Review, 5(3), 203–221. https://doi.org/10.1007/BF02214762
42.
McLellanT. M.CaldwellJ. A.LiebermanH. R. (2016). A review of caffeine’s effects on cognitive, physical and occupational performance. Neuroscience and Biobehavioral Reviews, 71, 294–312. https://doi.org/10.1016/j.neubiorev.2016.09.001
43.
MooreT. M.BasnerM.NasriniJ.HermosilloE.KabadiS.RoalfD. R.McGuireS.EckerA. J.RuparelK.PortA. M.JacksonC. T.DingesD. F.GurR. C. (2017). Validation of the cognition test battery for spaceflight in a sample of highly educated adults. Aerospace Medicine and Human Performance, 88(10), 937–946. https://doi.org/10.3357/AMHP.4801.2017
NindlB. C.BarnesB. R.AlemanyJ. A.FrykmanP. N.ShippeeR. L.FriedlK. E. (2007). Physiological consequences of U.S. army ranger training. Medicine and Science in Sports and Exercise, 39(8), 1380–1387. https://doi.org/10.1249/MSS.0b013e318067e2f7
46.
NindlB. C.LeoneC. D.TharionW. J.JohnsonR. F.CastellaniJ. W.PattonJ. F.MontainS. J. (2002). Physical performance responses during 72 h of military operational stress. Medicine and Science in Sports and Exercise, 34(11), 1814–1822. https://doi.org/10.1097/00005768-200211000-00019
47.
NobleB. J.BorgG. A. V.JacobsI.RuggeroC.KaiserP. (1983). A category-ratio perceived exertion scale: relationship to blood and muscle lactates and heart rate. Medicine and Science in Sports and Exercise, 15(6), 523–528.
48.
Ołpińska-LischkaM.KujawaK.WirthJ. A.Antosiak-CyrakK. Z.MaciaszekJ. (2020). The influence of 24-hr sleep deprivation on psychomotor vigilance in young women and men. Nature and Science of Sleep, 12, 125–134. https://doi.org/10.2147/NSS.S235385
49.
RosaE.EikenO.GrönkvistM.KölegårdR.DahlströmN.KnezI.LjungR.JönssonF. U.WillanderJ. (2020). Effects of fatigue on cognitive performance in long-duration simulated flight missions. Aviation Psychology and Applied Human Factors, 10(2), 82–93. https://doi.org/10.1027/2192-0923/a000191
50.
SamnS. W.PerelliL. P. (1982). Estimating aircrew fatigue: A technique with application to airlift operations. School of Aerospace Medicine Brooks Afb tx.
51.
SawA. E.MainL. C.GastinP. B. (2016). Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: A systematic review. British Journal of Sports Medicine, 50(5), 281–291. https://doi.org/10.1136/bjsports-2015-094758
52.
ShattuckN. L.MatsangasP.DahlmanA. S. (2018). Sleep and fatigue issues in military operations. In Sleep and combat-related post traumatic stress disorder. Springer (pp. 69–76).
53.
SmithC. D.CooperA. D.MerulloD. J.CohenB. S.HeatonK. J.ClaroP. J.SmithT. (2019). Sleep restriction and cognitive load affect performance on a simulated marksmanship task. Journal of Sleep Research, 28(3), e12637. https://doi.org/10.1111/jsr.12637
54.
TaylorY.MeratN.JamsonS. (2019). The effects of fatigue on cognitive performance in police officers and staff during a forward rotating shift pattern. Safety and Health at Work, 10(1), 67–74. https://doi.org/10.1016/j.shaw.2018.08.003
55.
ThomasM. L.RussoM. B. (2007). Neurocognitive monitors: toward the prevention of cognitive performance decrements and catastrophic failures in the operational environment. Aviation, Space, and Environmental Medicine, 78(5), B144–B152.
56.
TikuisisP.KeefeA. A.McLellanT. M.KamimoriG. (2004). Caffeine restores engagement speed but not shooting precision following 22 h of active wakefulness. Aviation, Space, and Environmental Medicine, 75(9), 771–776.
57.
Van DongenH. P.DingesD. F. (2005). Sleep, circadian rhythms, and psychomotor vigilance. Clinics in Sports Medicine, 24(2), 237–249. https://doi.org/10.1016/j.csm.2004.12.007
58.
Van DongenH. P.MaislinG.MullingtonJ. M.DingesD. F. (2003). The cumulative cost of additional wakefulness: Dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117–126. https://doi.org/10.1093/sleep/26.2.117
59.
VrijkotteS.RoelandsB.MeeusenR.PattynN. (2016). Sustained military operations and cognitive performance. Aerospace Medicine and Human Performance, 87(8), 718–727. https://doi.org/10.3357/AMHP.4468.2016
WatsonN.WatsonN. F.BadrM. S.BelenkyG.BliwiseD. L.BuxtonO. M.BuysseD.DingesD. F.GangwischJ.GrandnerM. A.KushidaC.MalhotraR. K.MartinJ. .LPatelS. R.QuanS. F.TasaliE.TweryM.CroftJ. B.MaherE.HealdJ. L. (2015). A joint consensus statement of the american academy of sleep medicine and sleep research society on the recommended amount of sleep for a healthy adult methodology and discussion. Journal of Clinical Sleep Medicine, 11(8), 591–592. https://doi.org/10.5664/jcsm.4758
62.
WeeksS. R.McAuliffeC. L.DuRusselD.PasquinaP. F. (2010). Physiological and psychological fatigue in extreme conditions: The military example. PM&R, 2(5), 438–441. https://doi.org/10.1016/j.pmrj.2010.03.023
63.
WilliamsonA. M.FeyerA. M. (2000). Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occupational and Environmental Medicine, 57(10), 649–655. https://doi.org/10.1136/oem.57.10.649
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
